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Updated: May 13, 2026
05:53
Intraoperative Ultrasound in Spinal Surgery
Published on: August 17, 2022
Lumbar pain with intracranial origin.
Vasiliki Perlepe1, Luc Haenecour, Thierry Duprez
1Cliniques Universitaires Saint-Luc - Radiology, Brussels, Belgium. vasilikiperlepe@gmail.com
Acta Radiologica (Stockholm, Sweden : 1987)
|February 26, 2013
Summary
A subdural hematoma (SDH) migrated from the brain to the lumbar spine, causing low-back pain. This case highlights a rare complication of intracranial SDH, emphasizing the need for thorough evaluation.
Area of Science:
- Neurology
- Neurosurgery
- Radiology
Background:
- Subdural hematomas (SDH) are typically intracranial.
- Spinal SDH is rare and often associated with specific causes like trauma or bleeding disorders.
Observation:
- A 48-year-old female patient presented with low-back pain radiating to the right leg.
- Magnetic resonance imaging (MRI) identified a subacute subdural hematoma (SDH) at the L4-L5 level of the lumbar spine.
- The patient had no history of trauma, surgery, lumbar puncture, or bleeding disorders that could explain the spinal SDH.
Findings:
- The patient had a history of intracranial SDH and cerebral contusions resulting from a fall months prior.
- A downward migration of the existing intracranial subdural hematoma was identified as the sole potential cause for the lumbar SDH.
- This case suggests a possible pathophysiological link between intracranial and spinal subdural hematomas.
Implications:
- The findings suggest that intracranial subdural hematomas may, in rare instances, extend or migrate caudally, leading to spinal subdural hematomas.
- This case expands the differential diagnosis for spontaneous lumbar subdural hematomas, including consideration of prior intracranial bleeding.
- Further investigation into the mechanisms of cerebrospinal fluid dynamics and dural anatomy may elucidate the pathway for such migrations.
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